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手术方法是否会影响与Hirschsprung相关的肠球炎风险? 跨门的斯温森式和内肠直肠拉透之间的比较

Azzahra Fatinnuha Azmi Prayogi Putri¹, Dwiki Afandy¹, Ahmad Zakiy Habibiy¹

¹Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

|January 8, 2026

概括

希尔施普朗相关肠球炎 (HAEC) 在经过门的斯文森样拉透 (TSLPT) 后发生的频率较低,而不是经过门的直肠内拉透 (TEPT). 手术后的白蛋白水平可能表明HAEC风险,特别是在为希尔施普隆病 (HSCR) 进行TEPT手术后.

科学领域:

儿科手术儿科手术
胃肠病学胃肠病学
手术并发症手术并发症

背景情况:

赫施普隆相关肠道炎 (HAEC) 是赫施普隆病 (HSCR) 的严重并发症.
诸如过门内肠直肠拉透 (TEPT) 和过门斯温森式拉透 (TSLPT) 等外科干预措施用于治疗HSCR.
将TEPT和TSLPT之间的HAEC发病率和风险因素进行比较,对于优化患者的治疗结果至关重要.

研究的目的:

为了比较TSLPT和TEPT后的HAEC在HSCR患者中的发生率.
为了确定与这些外科手术后的HAEC发展相关的潜在预测因素.

主要方法:

对于在2018年至2023年期间接受TEPT或TSLPT的HSCR患者的医疗记录的回顾性审查.
在HAEC诊断中,使用了已建立的评分系统,截止值为4和10.
统计分析比较了手术组之间的HAEC发生率,并检查了与临床因素的关联.

主要成果:

虽然在统计学上不显著 (p=0.056),但在TSLPT组的HAEC发病率在数字上较低 (6.9%与切断值≥4) 与TEPT组 (24.4%) 相比.
手术后的白蛋白水平与TEPT组的HAEC显著相关 (p=0.03) 并通过多变量分析 (p=0.047) 得到证实.
其他因素,如性别,年龄,角质结核病类型,营养状况和血红蛋白水平,与HAEC没有显著关联.

结论:

在HSCR患者中,TSLPT治疗后HAEC的发生率似乎比TEPT更低.
手术后的低albuminemia可能成为HAEC的潜在风险指标,特别是在接受过TEPT的患者中.
需要进一步的前性研究来验证这些发现并完善HAEC管理策略.

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